@include("system::admin.layouts._header")
<body>
<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form" method="post">
        <div class="layui-tab layui-tab-brief" lay-filter="docDemoTabBrief">

            <div class="layui-form-item">
                <label class="layui-form-label required">用户名</label>
                <div class="layui-input-block">
                    <input type="text" name="user_name" class="layui-input" lay-verify="required" lay-reqtext="请输入用户名"
                           placeholder="请输入用户名" value="">
                    <tip>填写用户名。</tip>
                </div>
            </div>

            <div class="layui-form-item">
                <label class="layui-form-label required">收货人</label>
                <div class="layui-input-block">
                    <input type="text" name="name" class="layui-input" lay-verify="required" lay-reqtext="请输入收货人"
                           placeholder="请输入收货人" value="">
                    <tip>填写收货人。</tip>
                </div>
            </div>

            <div class="layui-form-item">
                <label class="layui-form-label required">联系电话</label>
                <div class="layui-input-block">
                    <input type="text" name="telephone" class="layui-input" lay-verify="required" lay-reqtext="请输入联系电话"
                           placeholder="请输入联系电话" value="">
                    <tip>填写联系电话。</tip>
                </div>
            </div>

            <div class="layui-form-item">
                <label class="layui-form-label">省/市/县</label>
                <div class="layui-input-inline">
                    <select name="province_id" lay-filter="province_id" lay-verify="required">
                        <option value="">请选择省份</option>
                        @foreach($provinces as $item)
                            <option value="{{$item->id}}">{{$item->name}}</option>
                        @endforeach
                    </select>
                </div>

                <div class="layui-input-inline">
                    <select name="city_id" lay-filter="city_id" lay-verify="required">
                        <option value="">请选择城市</option>
                    </select>
                </div>

                <div class="layui-input-inline">
                    <select name="district_id" lay-filter="district_id" lay-verify="required">
                        <option value="">请选择区县</option>
                    </select>
                </div>
            </div>

            <div class="layui-form-item">
                <label class="layui-form-label">详细地址</label>
                <div class="layui-input-block">
                    <textarea name="address" class="layui-textarea" placeholder="请输入详细地址"></textarea>
                    <tip>填写详细地址。</tip>
                </div>
            </div>

            <div class="layui-form-item">
                <label class="layui-form-label">默认地址</label>
                <div class="layui-input-block">
                    <input type="radio" name="is_default" lay-skin="primary" checked value="0" title="否">
                    <input type="radio" name="is_default" lay-skin="primary" value="1" title="是">
                </div>
            </div>

            <div class="hr-line"></div>
            <div class="layui-form-item text-center">
                <input type="hidden" name="user_id" value="0">
                <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
                <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
            </div>
        </div>

    </form>
</div>

</body>
</html>
